| NPI | 1447713573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLIVER WISCO President 210-632-5544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology MOHS-Micrographic Surgery |
| Enumeration Date | 2019-04-06 |
| Last Update Date | 2019-04-06 |