| NPI | 1801391040 |
|---|---|
| Former Name | KRYSTAL MITCHELL-GBA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A180532) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 326417) |
| 207R00000X Internal Medicine (Licence: IL 1801391040) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2024-01-03 |