| NPI | 1477613891 |
|---|---|
| Former Name | SUSAN D TWILLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NM PA2005-0049) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA10005131) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2011-12-01 |