NPI | 1821051079 |
---|---|
Former Name | ANDREA L SLAUGHTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: MO 2009017535) |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MO 2009017535) |
207N00000X Dermatology (Licence: WI 48976-020) | |
Enumeration Date | 2006-04-10 |
Last Update Date | 2021-09-16 |