| NPI | 1376208868 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETSY J WERNLI President 920-482-0671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 2082S0105X Plastic Surgery Surgery of the Hand |
| 207ND0101X Dermatology MOHS-Micrographic Surgery | |
| 207ND0900X Dermatology Dermatopathology | |
| 207NI0002X Dermatology Clinical & Laboratory Dermatological Immunology | |
| 207NS0135X Dermatology Procedural Dermatology | |
| 207ZP0101X Pathology Anatomic Pathology | |
| 208200000X Plastic Surgery | |
| Enumeration Date | 2021-11-01 |
| Last Update Date | 2024-02-15 |