| NPI | 1003573593 |
|---|---|
| Former Name | JANIE MARIE LEATHERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MO 2026016384) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2025020967) |
| Enumeration Date | 2021-11-19 |
| Last Update Date | 2026-06-22 |