| NPI | 1770547994 |
|---|---|
| Former Name | SUSAN SHAW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 032809) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 32809) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2022-04-12 |