| NPI | 1144588047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GHEORGHE PUSTA CEO 512-960-5760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: AZ 11617) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: AZ RN081679) |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2018-02-28 |