NPI | 1134415888 |
---|---|
Former Name | MYRIAM L VEGA PENSO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: MD D94940) |
Additional Taxonomies | 207N00000X Dermatology (Licence: PA MT196728) |
Enumeration Date | 2011-06-21 |
Last Update Date | 2022-11-30 |