NPI | 1801973219 |
---|---|
Former Name | TAJ MAHALIA CHEROKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: WA MD00029104) |
Additional Taxonomies | 207N00000X Dermatology (Licence: AK 3125) |
Enumeration Date | 2006-11-01 |
Last Update Date | 2007-07-08 |