NPI | 1134147325 |
---|---|
Former Name | SUSAN PAIGE HERTWECK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: KY 25239) |
Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: KY 25239) |
Enumeration Date | 2006-07-17 |
Last Update Date | 2020-05-26 |