| NPI | 1184624801 |
|---|---|
| Former Name | SUSAN ELAINE PIETROWSKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IN 10000623A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10000623A) |
| 363AS0400X Physician Assistant, Surgical (Licence: IL 085001844) | |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2021-03-19 |