| NPI | 1023195393 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE J CARPENTER Owner 251-433-7946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: AL 00021817) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |