| NPI | 1912054719 |
|---|---|
| Former Name | SUSAN M FOWLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0210X Pediatrics, Pediatric Nephrology (Licence: VA 0101249088) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2009-01001) |
| 208D00000X General Practice (Licence: VA 0101249088) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2024-09-03 |