| NPI | 1538911755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANINE D MILLER President 907-276-1315 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2024-04-02 |
| Last Update Date | 2024-06-25 |