Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0101X | MOHS-Micrographic Surgeon | 66941 | MN |
NPI | 1023460243 |
---|---|
Provider Name | Ji Won Ahn |
First Address | Rochester, MN 55905-0001 |
Second Address | Pittsburgh, PA 15213-3427 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2016 |
Last Update Date | 05/11/2021 |