| NPI | 1275591315 |
|---|---|
| Former Name | CLANCY JOHNSON SINIPES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AL 0027325) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: AL 00027325) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: AL 00027325) | |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2016-05-16 |