| NPI | 1023377082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ILYA REYTER President 818-907-7546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA a79982) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA a79982) |
| 207ND0900X Dermatology, Dermatopathology (Licence: CA a79982) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: CA a79982) | |
| Enumeration Date | 2012-05-11 |
| Last Update Date | 2025-06-13 |