NPI | 1083954226 |
---|---|
Entity Type | Organization |
Authorized Contact | REBECCA LOUIS FITZGERALD President / CEO 323-464-8046 |
Organization Subpart ? | No |
Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: CA A49000) |
Enumeration Date | 2013-02-25 |
Last Update Date | 2013-02-25 |