| NPI | 1093408882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS KNACKSTEDT Owner 919-762-6845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Additional Taxonomies | 207N00000X Dermatology |
| 207NS0135X Dermatology, Procedural Dermatology | |
| Enumeration Date | 2023-05-30 |
| Last Update Date | 2023-05-30 |