| NPI | 1821045329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ESTELLE B MILLER Practice Manager 505-872-4700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NM 2000-166) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: NM 2000-166) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: NM 2002-0450) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: NM R46867NM) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: NM MD2005-0405) | |
| 207N00000X Dermatology (Licence: NM 2002-0450) | |
| 207N00000X Dermatology (Licence: NM R46867NM) | |
| 207N00000X Dermatology (Licence: NM MD2005-0405) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NM 2000-166) | |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2008-03-06 |