NPI | 1447453402 |
---|---|
Former Name | STEPHANIE DIAMANTIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: NC 2007-01974) |
Additional Taxonomies | 207N00000X Dermatology (Licence: NC 2007-01974) |
207NS0135X Dermatology Procedural Dermatology (Licence: NC 2007-01974) | |
Enumeration Date | 2007-06-07 |
Last Update Date | 2014-11-25 |