| NPI | 1205242252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETH ANNE SCHULZ-BUTULIS President 984-242-0510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NC 203528) |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2022-11-16 |