Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | ME147897 | FL |
NPI | 1023490018 |
---|---|
Provider Name | Jillian Frieder |
First Address | Boca Raton, FL 33487-5720 |
Second Address | Boca Raton, FL 33487-5720 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2015 |
Last Update Date | 04/10/2021 |