| NPI | 1538554522 |
|---|---|
| Former Name | NATALIE MARIE WALCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: GA 91550) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OH 35.136867) |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2022-06-10 |