| NPI | 1366414054 |
|---|---|
| Former Name | SUSAN MANN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD172023) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME96215) |
| 208000000X Pediatrics (Licence: AZ 19006) | |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2018-06-22 |