NPI | 1225423742 |
---|---|
Former Name | VIRGINIA NELL HASELDEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: KY 52867) |
Additional Taxonomies | 207N00000X Dermatology (Licence: IN 01082183A) |
Enumeration Date | 2015-04-01 |
Last Update Date | 2019-07-10 |