| NPI | 1164695565 |
|---|---|
| Former Name | TAMARA LAZIC |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 266671) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CT 051035) |
| Enumeration Date | 2008-04-07 |
| Last Update Date | 2022-02-03 |