| NPI | 1144608266 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROOKS A BAHR Owner 801-298-1514 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207N00000X Dermatology (Licence: UT 3735441205) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery | |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2021-12-14 |