| NPI | 1225175441 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY LEE ROMINE Practice Administrator 602-954-7546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AZ 31198) |
| Additional Taxonomies | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: AZ 31198) |
| 207NS0135X Dermatology Procedural Dermatology (Licence: AZ 31198) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2014-11-14 |