| NPI | 1366611311 |
|---|---|
| Former Name | SUSUN BELLEW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NV DO1612) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: AZ 005520) |
| Enumeration Date | 2008-02-25 |
| Last Update Date | 2016-03-15 |