| NPI | 1194953695 |
|---|---|
| Former Name | SUZANNE SANDRA BEATTY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS10891) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL n/a) |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2021-08-18 |