| NPI | 1164605150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA M BENEDICT Owner 404-352-1730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 207N00000X Dermatology |
| Enumeration Date | 2007-12-12 |
| Last Update Date | 2012-02-07 |