| NPI | 1063608107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE LIU Dr. 949-863-0988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA A61446) |
| Enumeration Date | 2007-09-21 |
| Last Update Date | 2008-06-17 |