NPI | 1730373101 |
---|---|
Entity Type | Organization |
Authorized Contact | SUWAPANG PATTUMMADITH President 909-592-2816 |
Organization Subpart ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: CA A32823) |
Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: CA A32823) |
207NS0135X Dermatology, Procedural Dermatology (Licence: CA A32823) | |
Enumeration Date | 2007-08-29 |
Last Update Date | 2008-03-27 |