| NPI | 1063909182 |
|---|---|
| Former Name | SUSAN HAGEMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR E13451) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2018-04-14 |
| Last Update Date | 2024-02-27 |