NPI | 1932495827 |
---|---|
Former Name | JULIE ELLYN HERINGHAUSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: MI 4301098875) |
Additional Taxonomies | 207N00000X Dermatology (Licence: NC 2017-00834) |
Enumeration Date | 2011-06-20 |
Last Update Date | 2022-10-10 |