| NPI | 1376724575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BABAR K RAO Owner 559-446-1070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: NJ 25MA07004000) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NJ 25MA07004000) |
| 207ND0900X Dermatology, Dermatopathology (Licence: NJ 25MA07004000) | |
| Enumeration Date | 2007-11-16 |
| Last Update Date | 2009-09-28 |