NPI | 1457732885 |
---|---|
Former Name | ALEXANDRA OWENS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: VA 0101268348) |
Additional Taxonomies | 207N00000X Dermatology (Licence: MD D0088444) |
207R00000X Internal Medicine (Licence: FL TRN22091) | |
Enumeration Date | 2015-06-11 |
Last Update Date | 2024-05-02 |