| NPI | 1083066450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEIL P SUPERFON Physician 602-277-1449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0001X |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology |
| Enumeration Date | 2016-07-08 |
| Last Update Date | 2016-07-08 |