| NPI | 1992560213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETSY J WERNLI President 920-482-0671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology |
| Additional Taxonomies | 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology |
| 207ZP0101X Pathology, Anatomic Pathology | |
| Enumeration Date | 2024-02-15 |
| Last Update Date | 2024-02-15 |