| NPI | 1659515658 |
|---|---|
| Former Name | JESSICA MOENNICH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: CO 52384) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CO 52384) |
| Enumeration Date | 2009-04-22 |
| Last Update Date | 2024-03-26 |