| NPI | 1043211907 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM K BROKKEN Owner 805-682-6455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: CA C33750) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2008-06-24 |