| NPI | 1396074134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMI MIMS Credentialing Coordinator 281-364-8844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Enumeration Date | 2009-12-07 |
| Last Update Date | 2025-10-01 |