NPI | 1760679203 |
---|---|
Former Name | MARY TAYLOR BENOIT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: SC 30772) |
Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME144280) |
Enumeration Date | 2007-09-28 |
Last Update Date | 2022-10-12 |