NPI | 1982067120 |
---|---|
Former Name | JACQUELYN MARJORIE SWIETLIK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: WI 70038-20) |
Additional Taxonomies | 207N00000X Dermatology (Licence: NC 2020-01917) |
Enumeration Date | 2016-04-04 |
Last Update Date | 2021-06-27 |