| NPI | 1013994367 |
|---|---|
| Former Name | JEANNE ELIZABETH PRUSS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CO 43770) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: CO 43770) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2015-10-21 |