NPI | 1023542826 |
---|---|
Former Name | VALERIE ANN GORDON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: NY 328333) |
Additional Taxonomies | 207N00000X Dermatology (Licence: NY 328333) |
Enumeration Date | 2017-04-18 |
Last Update Date | 2024-03-12 |