| NPI | 1871375055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLAIR HARRIS Member/Organizer 435-720-3697 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| 207NP0225X Dermatology, Pediatric Dermatology | |
| 207NS0135X Dermatology, Procedural Dermatology | |
| Enumeration Date | 2023-10-20 |
| Last Update Date | 2023-10-25 |