NPI | 1073053211 |
---|---|
Former Name | JOANNA SUSAN EMILIO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: NY 294563) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2017-03-07 |
Last Update Date | 2024-06-03 |