| NPI | 1922279496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DULL Billing Manager 702-430-5333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 174400000X Specialist (Licence: IL 036119939) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery | |
| Enumeration Date | 2008-03-12 |
| Last Update Date | 2023-06-28 |