NPI | 1811552029 |
---|---|
Former Name | GEORGEANNE EMERSON ZITSCH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: MO 2020022923) |
Enumeration Date | 2019-05-02 |
Last Update Date | 2024-06-21 |