| NPI | 1336892850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE HAWKINS Office Manager 417-889-3332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Additional Taxonomies | 207N00000X Dermatology |
| Enumeration Date | 2022-02-03 |
| Last Update Date | 2022-02-03 |