| NPI | 1407919467 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD N. BOCK Owner 209-956-4260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA G24211) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2020-08-22 |