NPI | 1053823120 |
---|---|
Doing Business As | VIVIDA DERMATOLOGY |
Entity Type | Organization |
Authorized Contact | DOUGLAS F FIFE President/CEO 702-255-6647 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207N00000X Dermatology |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
Enumeration Date | 2017-10-30 |
Last Update Date | 2018-05-09 |