| NPI | 1114393295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETSY J WERNLI President 920-482-0691 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology MOHS-Micrographic Surgery |
| 207NS0135X Dermatology Procedural Dermatology | |
| Enumeration Date | 2015-08-12 |
| Last Update Date | 2021-10-14 |