NPI | 1659654598 |
---|---|
Former Name | BONITA KOZMA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: MI 4301509642) |
Additional Taxonomies | 207N00000X Dermatology (Licence: CA 137074) |
Enumeration Date | 2011-09-27 |
Last Update Date | 2023-08-17 |