NPI | 1467655431 |
---|---|
Former Name | HOLLY JEANETTE WIMPEE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: AL 35937) |
Additional Taxonomies | 207N00000X Dermatology (Licence: PA MD445320) |
207N00000X Dermatology (Licence: KY 47508) | |
Enumeration Date | 2007-06-07 |
Last Update Date | 2019-03-13 |