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 |