NPI | 1023346236 |
---|---|
Former Name | SUSAN MARTY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA031908) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110003201) |
363A00000X Physician Assistant (Licence: MD C06789) | |
Enumeration Date | 2009-11-28 |
Last Update Date | 2025-07-27 |