NPI | 1598981763 |
---|---|
Former Name | KATHRYN ELISE BOYSE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: CA 123615) |
Additional Taxonomies | 207N00000X Dermatology (Licence: OH 35.090979) |
207N00000X Dermatology (Licence: OH 57.012401) | |
Enumeration Date | 2007-04-17 |
Last Update Date | 2018-08-10 |