| NPI | 1942442355 |
|---|---|
| Former Name | SUZANNE M SIDES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD161218) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2019-09-19 |