NPI | 1457495848 |
---|---|
Former Name | BRENDA LEE BARTLETT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: MD MD0075639) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2007-02-18 |
Last Update Date | 2021-10-18 |