| NPI | 1083957906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY KEMPTON BINGHAM Owner / Managing Member 111-111-1111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: AZ 5198) |
| Enumeration Date | 2013-03-28 |
| Last Update Date | 2013-03-28 |