| NPI | 1013965805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY FRITCH Manager 913-451-3030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: KS 18382) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: KS 18382) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2013-01-31 |