| NPI | 1760356208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONA LEDDY Director 907-267-5890 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207NP0225X Dermatology, Pediatric Dermatology |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery | |
| Enumeration Date | 2025-09-29 |
| Last Update Date | 2025-09-29 |