| NPI | 1609040427 |
|---|---|
| Former Name | JOANNE RUTH HUMPHREY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: ND 14005) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME109271) |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2016-06-24 |