NPI | 1710969183 |
---|---|
Former Name | ALICIA DAWN JONES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: MO 2007013543) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35084094) |
Enumeration Date | 2005-11-18 |
Last Update Date | 2012-07-27 |