NPI | 1720467194 |
---|---|
Former Name | GRETCHEN LYNN DELUKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 305158) |
Additional Taxonomies | 207N00000X Dermatology (Licence: NY 305158) |
Enumeration Date | 2015-05-19 |
Last Update Date | 2020-10-28 |