| NPI | 1063729309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIANNE W ROSEN Owner 843-723-6529 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology |
| Enumeration Date | 2010-09-08 |
| Last Update Date | 2012-01-30 |