| NPI | 1548874449 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE JOSEPH OVERMAN Sole Member 415-802-1310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Additional Taxonomies | 207N00000X Dermatology |
| Enumeration Date | 2020-09-08 |
| Last Update Date | 2023-07-18 |