| NPI | 1063279420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA SUZANNE MOSHER Director 617-710-6585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Additional Taxonomies | 207N00000X Dermatology |
| 207ND0900X Dermatology, Dermatopathology | |
| 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology | |
| 207NS0135X Dermatology, Procedural Dermatology | |
| Enumeration Date | 2024-03-04 |
| Last Update Date | 2024-06-23 |