| NPI | 1144420936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BELEN FRED BODIE Owner 251-342-7880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: AL 6998) |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2008-07-08 |