| NPI | 1700119195 |
|---|---|
| Other Name | MIA DE LEON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA CA497626) |
| Additional Taxonomies | 207NS0135X Dermatology Procedural Dermatology (Licence: CA NP9810) |
| Enumeration Date | 2009-09-16 |
| Last Update Date | 2024-08-21 |