| NPI | 1215440011 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRY ALLISON LAVIGNE President 207-706-5030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery |
| Additional Taxonomies | 207N00000X Dermatology |
| 207NI0002X Dermatology Clinical & Laboratory Dermatological Immunology | |
| 207NP0225X Dermatology Pediatric Dermatology | |
| 207NS0135X Dermatology Procedural Dermatology | |
| Enumeration Date | 2017-11-15 |
| Last Update Date | 2021-10-25 |