| NPI | 1417375221 |
|---|---|
| Former Name | SUSAN K LIGHT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 64848-20) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA MD-46764) |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2021-06-17 |