NPI | 1174183925 |
---|---|
Entity Type | Organization |
Authorized Contact | RONALD L MOY Medical Doctor 310-274-5327 |
Organization Subpart ? | No |
Primary Taxonomy | 207N00000X Dermatology |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
207NS0135X Dermatology, Procedural Dermatology | |
Enumeration Date | 2019-06-14 |
Last Update Date | 2019-06-14 |