| NPI | 1174501886 |
|---|---|
| Former Name | SUSAN MARIE HAGEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NJ 25MA04095600) |
| Additional Taxonomies | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: NJ 25MA0409500) |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2021-06-13 |