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Individual
MISS SUZANNE FAIR ROTH
Active
Individual
MISS SUZANNE FAIR ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
14948
CA
363LF0000X
Family Nurse Practitioner
Primary
RN 252378
CA
Other
Enumeration date
03/21/2006
Last updated
08/09/2013
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