| NPI | 1679706139 |
|---|---|
| Former Name | ANNIE MACDOUGALL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NJ 25MA05757000) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00223900) |
| 363A00000X Physician Assistant (Licence: 25MA05757000) | |
| Enumeration Date | 2009-09-01 |
| Last Update Date | 2014-06-03 |