NPI | 1063490167 |
---|---|
Former Name | DAWN NICOLE JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: MD D0063740) |
Additional Taxonomies | 208600000X Surgery (Licence: DC MD30734) |
208600000X Surgery (Licence: DE C1-0023818) | |
Enumeration Date | 2006-01-09 |
Last Update Date | 2024-11-25 |