NPI | 1295197853 |
---|---|
Former Name | CAROLINE MAYFIELD WEST |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: CO DR.0063933) |
Additional Taxonomies | 207N00000X Dermatology (Licence: UT 10513568-1205) |
Enumeration Date | 2016-03-23 |
Last Update Date | 2021-12-15 |