| NPI | 1053334045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA LYNN SMITH President 803-802-3376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: SC 15514) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: SC 29310) |
| 207NP0225X Dermatology, Pediatric Dermatology (Licence: SC 15514) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2007-10-29 |