| NPI | 1225461924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS R SNAVELY Sole Proprietor/Owner Of Ein 512-767-7546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Additional Taxonomies | 207N00000X Dermatology |
| 207ND0900X Dermatology, Dermatopathology | |
| Enumeration Date | 2013-08-16 |
| Last Update Date | 2013-08-16 |