| NPI | 1194479972 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLEY SUTHERLAND Owner 410-533-4200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology |
| 261Q00000X Clinic/Center | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery | |
| 207NP0225X Dermatology, Pediatric Dermatology | |
| Enumeration Date | 2022-02-09 |
| Last Update Date | 2023-03-26 |