| NPI | 1841929908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BURT I FAIBISOFF Physician/Owner 602-476-4074 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 208200000X Plastic Surgery | |
| Enumeration Date | 2022-06-06 |
| Last Update Date | 2025-01-16 |