| NPI | 1346403755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENT P ELLERBROEK Medical Doctor 319-235-6323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: IA 202213) |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2008-10-14 |