NPI | 1104847714 |
---|---|
Entity Type | Organization |
Authorized Contact | KELLI NEWMAN Credentialing Specialist 252-668-7026 |
Organization Subpart ? | No |
Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: NC 27881) |
Enumeration Date | 2006-07-21 |
Last Update Date | 2021-08-04 |