| NPI | 1790101525 |
|---|---|
| Former Name | SUSAN HARRIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: RI MD15043) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 48331) |
| 208000000X Pediatrics (Licence: MA 258441) | |
| 208000000X Pediatrics (Licence: TX H4194) | |
| Enumeration Date | 2014-03-18 |
| Last Update Date | 2023-12-14 |