| NPI | 1104950013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE CENTURION Office Manager 732-679-6738 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2016-01-22 |