| NPI | 1174712228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN PATRICK O'QUINN President 210-558-6234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Enumeration Date | 2007-10-15 |
| Last Update Date | 2015-08-12 |