| NPI | 1649611476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE M MOENSTER Member 520-458-1787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Additional Taxonomies | 207N00000X Dermatology (Licence: AZ 006021) |
| 208200000X Plastic Surgery (Licence: AZ 006018) | |
| Enumeration Date | 2013-07-09 |
| Last Update Date | 2023-07-26 |