Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0101X | MOHS-Micrographic Surgeon | 33945 | SC |
NPI | 1447575931 |
---|---|
Provider Name | Jane Unaeze |
First Address | Greenville, SC 29607-4105 |
Second Address | Greenville, SC 29607-4105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2010 |
Last Update Date | 30/01/2012 |