| NPI | 1629427497 |
|---|---|
| Former Name | JESALYN AUTUMN MERRITT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: KS 04-45028) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: KS 04-45028) |
| Enumeration Date | 2016-06-12 |
| Last Update Date | 2021-08-26 |