| 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 | 2017-04-06 |