NPI | 1881682144 |
---|---|
Former Name | SUZANNE MCLEOD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME142844) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 26551) |
Enumeration Date | 2005-10-11 |
Last Update Date | 2021-05-27 |