| NPI | 1134873185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON BEAL Medical Director 314-422-6882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology |
| 207NP0225X Dermatology, Pediatric Dermatology | |
| 207NS0135X Dermatology, Procedural Dermatology | |
| 207N00000X Dermatology | |
| Enumeration Date | 2022-02-08 |
| Last Update Date | 2025-11-14 |