Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0900X | Dermatopathologist | ME64945 | FL |
NPI | 1386649853 |
---|---|
Provider Name | Elise Chang Hillmann |
First Address | Jupiter, FL 33458-7546 |
Second Address | Jupiter, FL 33458-7546 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2005 |
Last Update Date | 25/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F41846 | (02) | FL |