| NPI | 1154616811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE HENDRICKSON Practice Manager 561-745-8602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: FL ME64945) |
| Enumeration Date | 2011-06-10 |
| Last Update Date | 2011-10-25 |