NPI | 1851870208 |
---|---|
Entity Type | Organization |
Authorized Contact | STEPHANIE DURRETT Office Manager 424-352-0049 |
Organization Subpart ? | No |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 028306) |
Additional Taxonomies | 207N00000X Dermatology (Licence: CA 028306) |
Enumeration Date | 2018-08-07 |
Last Update Date | 2018-08-20 |