NPI | 1790041853 |
---|---|
Former Name | ISABELA TOLLINI WIECZOREK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: VA 0101262561) |
Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: VA 0101262561) |
Enumeration Date | 2012-04-03 |
Last Update Date | 2022-07-21 |