| 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 |