NPI | 1861719494 |
---|---|
Former Name | SASHA NICOLE JENKINS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: OH 35. 123300) |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: GA 69679) |
207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NC 2016-00779) | |
Enumeration Date | 2010-04-21 |
Last Update Date | 2017-04-20 |