| NPI | 1952563702 |
|---|---|
| Former Name | ELISABETH SUSAN MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 5101017747) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO DR.0049778) |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2023-09-05 |