| NPI | 1003518663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY EMERSON Owner 601-589-1810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology |
| Enumeration Date | 2023-03-20 |
| Last Update Date | 2023-09-19 |