| NPI | 1629303011 |
|---|---|
| Former Name | SUZANNE MARIE O'LEAR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2009035299) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 04-34049) |
| Enumeration Date | 2009-10-02 |
| Last Update Date | 2018-05-02 |