| NPI | 1497776579 |
|---|---|
| Former Name | KELLY ROSE TIERNEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: NJ 25ma09419600) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MA 244172) |
| 207ND0900X Dermatology, Dermatopathology (Licence: MA 244172) | |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2020-02-18 |