| NPI | 1003105198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETSY J WERNLI President 960-482-0671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology |
| 207ND0900X Dermatology, Dermatopathology | |
| 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery | |
| 207ZP0101X Pathology, Anatomic Pathology | |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2018-05-21 |