NPI | 1548222151 |
---|---|
Former Name | AMBER L RECK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: VA 0101271787) |
Additional Taxonomies | 207N00000X Dermatology (Licence: NC 2008-00854) |
Enumeration Date | 2006-04-06 |
Last Update Date | 2025-01-02 |