| NPI | 1497975874 |
|---|---|
| Former Name | SUSANNAH VIRGINIA QUISLING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TN MD0000046118) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IA 37041) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2014-11-11 |