NPI | 1144413055 |
---|---|
Former Name | ALIYA COURTNEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MT191376) |
Additional Taxonomies | 207N00000X Dermatology (Licence: PA MT191376) |
Enumeration Date | 2007-08-23 |
Last Update Date | 2007-08-23 |