| NPI | 1033250063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA COOK Manager 559-713-0117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA a68280) |
| Enumeration Date | 2007-02-11 |
| Last Update Date | 2011-03-25 |