| NPI | 1891779450 |
|---|---|
| Former Name | SUSAN D LACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX J4278) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX J4278) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2018-07-05 |