| NPI | 1598323362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS JACKSON FIFE Physician 702-255-6647 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2019-06-05 |