| NPI | 1740633015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRET BLACKHART Managing Partner 775-882-8777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: NV 193400000X) |
| Enumeration Date | 2016-07-21 |
| Last Update Date | 2016-09-08 |