| NPI | 1164715884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAFNIS C. CARRANZA Owner 731-784-4300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: TN 43760) |
| Enumeration Date | 2011-05-27 |
| Last Update Date | 2011-05-27 |