Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 1108516 | ME |
N | 207N00000X | Dermatologist | 234038 | MA |
N | 207N00000X | Dermatologist | 24408 | NE |
Y | 207NS0135X | Procedural Dermatology | 41903 | AZ |
NPI | 1306010467 |
---|---|
Provider Name | Ms. Brenda Marie Latowsky |
First Address | Scottsdale, AZ 85255-4134 |
Second Address | Scottsdale, AZ 85255-4134 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2008 |
Last Update Date | 26/09/2014 |