NPI | 1053450957 |
---|---|
Other Name | TRACY D BRADY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: OK 23494) |
Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: OK 23494) |
Enumeration Date | 2007-02-06 |
Last Update Date | 2023-07-13 |