| NPI | 1679613871 |
|---|---|
| Former Name | ALIA JANINE SAMPSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: GA 64786) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: KY IP975) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2011-04-20 |