NPI | 1063779072 |
---|---|
Former Name | JENNIFER MICHELLE CORBIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CO DR.0058205) |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL ME 131766) |
Enumeration Date | 2012-04-15 |
Last Update Date | 2024-07-19 |