| NPI | 1982858478 |
|---|---|
| Former Name | SUSAN LYNN CARNINE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60237462) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ID M10896) |
| 207R00000X Internal Medicine (Licence: UT 71526001205) | |
| Enumeration Date | 2008-11-10 |
| Last Update Date | 2021-06-28 |