| NPI | 1487042636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW J ELIAS Manager Member 415-802-1310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: FL OS9756) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL OS9756) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL OS9756) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: FL OS9756) | |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: FL OS9756) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: FL OS9756) | |
| Enumeration Date | 2014-12-22 |
| Last Update Date | 2024-12-13 |