NPI | 1265882690 |
---|---|
Former Name | WHITNEY ANNE TALBOTT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: TX U4850) |
Additional Taxonomies | 207N00000X Dermatology (Licence: NJ 25MA10809600) |
207N00000X Dermatology (Licence: NY 39020000X) | |
Enumeration Date | 2016-06-16 |
Last Update Date | 2023-10-23 |