| NPI | 1720705114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSA STOCKER Owner/Provider 515-865-4291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2022-10-26 |
| Last Update Date | 2022-10-26 |