| NPI | 1447588280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLAKE D. ALEXANDER Owner 209-578-5072 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA C52849) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CA C52849) |
| Enumeration Date | 2009-12-04 |
| Last Update Date | 2009-12-04 |