| NPI | 1124624028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL L CHRISTIANSEN Sole Proprietor 940-923-9960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2020-12-07 |
| Last Update Date | 2021-01-29 |