| NPI | 1194225268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE ROGERS Credentialing 763-367-7110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology |
| Enumeration Date | 2018-02-15 |
| Last Update Date | 2022-09-06 |