| NPI | 1982816138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER SIMON HERMAN President 915-544-3808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX E3304) |
| Additional Taxonomies | 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: TX E3304) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: TX E3304) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: TX E3304) | |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: TX E3304) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2014-03-06 |