| NPI | 1730490400 |
|---|---|
| Former Name | JENNIFER CHU SONG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX Q3426) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX Q3426) |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2022-11-21 |