NPI | 1346335189 |
---|---|
Former Name | KATHLEEN SUZANNE SUCKOW |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MT 11368) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 4193) |
Enumeration Date | 2006-10-04 |
Last Update Date | 2024-04-05 |