| 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 |