| NPI | 1285822346 |
|---|---|
| Former Name | SUSAN MARY CLEETUS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX M8668) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM MD2007-0094) |
| Enumeration Date | 2007-10-12 |
| Last Update Date | 2009-04-07 |