| NPI | 1154131233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA ABBAN Physician 224-800-1668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery | |
| Enumeration Date | 2025-01-10 |
| Last Update Date | 2025-10-29 |