| NPI | 1194055699 |
|---|---|
| Former Name | MARY SOCKOLOV |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX Training) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2010-01-05 |
| Last Update Date | 2015-07-09 |