| NPI | 1427340389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA MANNING Practice Administrator 602-971-0950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: AZ 41903) |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2011-08-18 |