| NPI | 1003905001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI J GIBBONS Business Manager 775-336-3624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2012-05-17 |