NPI | 1053579862 |
---|---|
Entity Type | Organization |
Authorized Contact | EDWARD LAIN Md 225-303-9500 |
Organization Subpart ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: LA MD.200242) |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: LA MD.200242) |
207ND0900X Dermatology, Dermatopathology (Licence: LA MD.200242) | |
207NS0135X Dermatology, Procedural Dermatology (Licence: LA MD.200242) | |
Enumeration Date | 2008-05-28 |
Last Update Date | 2025-04-29 |