NPI | 1013445071 |
---|---|
Former Name | MALIA B GROSSKREUTZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: KS 94-09169) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 94-09169) |
Enumeration Date | 2017-06-02 |
Last Update Date | 2023-11-16 |