NPI | 1497378046 |
---|---|
Former Name | GRACE K SUK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 1016183) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 69675) |
207Q00000X Family Medicine (Licence: MN 30810) | |
Enumeration Date | 2020-05-18 |
Last Update Date | 2024-01-16 |