Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 64741 | AZ |
Y | 207ND0900X | Dermatopathologist | 64741 | AZ |
NPI | 1427404102 |
---|---|
Provider Name | Dr. Nikoleta Brankov |
First Address | Chandler, AZ 85286-6160 |
Second Address | Chandler, AZ 85286-6160 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2016 |
Last Update Date | 04/02/2022 |