| NPI | 1316656721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERONICA SANCHEZ Manager 262-754-4488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Additional Taxonomies | 207N00000X Dermatology |
| Enumeration Date | 2022-11-15 |
| Last Update Date | 2022-11-17 |