| NPI | 1235229915 |
|---|---|
| Former Name | SUSAN ANGELLE BOACKLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: CO CDRH.0035598) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: TX H7909) |
| 207RR0500X Internal Medicine, Rheumatology (Licence: LA 335634) | |
| 207RR0500X Internal Medicine, Rheumatology (Licence: CO 35598) | |
| 207RR0500X Internal Medicine, Rheumatology (Licence: AL MD.43902) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2025-12-04 |