| NPI | 1942199500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACHARY CORONADO Administrator 623-521-9113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Additional Taxonomies | 207N00000X Dermatology |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2025-06-30 |
| Last Update Date | 2025-06-30 |