| NPI | 1831227289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATHEW M CANNAVA President 907-262-7546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Additional Taxonomies | 174400000X Specialist |
| 207N00000X Dermatology | |
| 207ND0900X Dermatology, Dermatopathology | |
| 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology | |
| 207NP0225X Dermatology, Pediatric Dermatology | |
| 207NS0135X Dermatology, Procedural Dermatology | |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2017-12-06 |