| NPI | 1841266293 |
|---|---|
| Former Name | SUZANNE LYNNE DEVEREAUX |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 46550) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD425915) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2021-06-08 |