NPI | 1275973398 |
---|---|
Former Name | LARK JULIE GREENWALD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: WA MD60840220) |
Additional Taxonomies | 207N00000X Dermatology (Licence: MT 79073) |
207N00000X Dermatology (Licence: CA 148774) | |
Enumeration Date | 2013-07-03 |
Last Update Date | 2024-01-16 |