| NPI | 1083448039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA RUTH PETERMAN Md 443-351-3376 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery |
| Additional Taxonomies | 174400000X Specialist |
| 207N00000X Dermatology | |
| Enumeration Date | 2024-08-30 |
| Last Update Date | 2024-08-30 |