NPI | 1982136586 |
---|---|
Former Name | KERRY DIANTHA HEITMILLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: CA 177050) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207R00000X Internal Medicine (Licence: MA 287028) | |
Enumeration Date | 2017-04-02 |
Last Update Date | 2025-10-14 |