| NPI | 1932182763 |
|---|---|
| Former Name | SUSAN RENEE ANDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MO 106273) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 106273) |
| Enumeration Date | 2005-11-25 |
| Last Update Date | 2014-09-25 |