NPI | 1417947060 |
---|---|
Former Name | TOMI LEE PANDOLFINO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: CA a97586) |
Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: CA a97586) |
Enumeration Date | 2005-10-25 |
Last Update Date | 2007-07-11 |