| NPI | 1851586713 |
|---|---|
| Former Name | SUSAN CAROL VAUGHN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AR PT2020-003) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NV PA1941) |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2020-01-22 |