| NPI | 1932231081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROWAN E TICHENOR President 307-266-2772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WY 2634A) |
| Additional Taxonomies | 207ND0900X Dermatology Dermatopathology (Licence: WY 2634A) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2007-10-03 |