NPI | 1316054398 |
---|---|
Former Name | VALERIE L JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: AZ 005078) |
Additional Taxonomies | 207N00000X Dermatology (Licence: FL OS9022) |
Enumeration Date | 2006-08-24 |
Last Update Date | 2016-01-26 |