NPI | 1407921935 |
---|---|
Former Name | SUSAN FRANCES SUMERGRAD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: LA 022649) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 022649) |
Enumeration Date | 2006-11-21 |
Last Update Date | 2024-08-28 |