NPI | 1215269097 |
---|---|
Entity Type | Organization |
Authorized Contact | PADMAN A MENON President 757-825-1846 |
Organization Subpart ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: VA 0101022994) |
Additional Taxonomies | 207N00000X Dermatology (Licence: NC 200301017) |
Enumeration Date | 2010-02-04 |
Last Update Date | 2010-12-20 |