| NPI | 1699968305 |
|---|---|
| Former Name | ADRIANNA JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: CA A116404) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA A116404) |
| 207N00000X Dermatology (Licence: TX P3009) | |
| 207R00000X Internal Medicine (Licence: MD P21900) | |
| Enumeration Date | 2007-08-26 |
| Last Update Date | 2022-07-05 |