NPI | 1982729521 |
---|---|
Former Name | SUSAN LYNN EVERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME129885) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036105621) |
207Q00000X Family Medicine (Licence: OR MD168061) | |
Enumeration Date | 2007-03-20 |
Last Update Date | 2017-03-13 |