NPI | 1205945151 |
---|---|
Former Name | SUSAN ELIZABETH STEPHENS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA G 080393) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OR MD 21292) |
Enumeration Date | 2006-08-30 |
Last Update Date | 2009-02-25 |