| NPI | 1164024394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM F KIVETT Owner 707-291-5096 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology MOHS-Micrographic Surgery |
| 2082S0105X Plastic Surgery Surgery of the Hand | |
| 2086S0122X Surgery Plastic and Reconstructive Surgery | |
| Enumeration Date | 2020-11-12 |
| Last Update Date | 2021-02-05 |