NPI | 1275559023 |
---|---|
Former Name | JENNIFER MARIE LUNG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: AZ 35481) |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: AZ 35481) |
Enumeration Date | 2006-07-14 |
Last Update Date | 2023-03-07 |