| NPI | 1083953137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES KEANE Owner/Administrator 678-448-8276 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: LA MD.205964) |
| Enumeration Date | 2013-02-10 |
| Last Update Date | 2013-07-18 |