| NPI | 1104006030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT A ROSS President 239-261-3082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME0057073) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME0053679) |
| Enumeration Date | 2007-11-08 |
| Last Update Date | 2007-11-08 |