| NPI | 1225918220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RADHA MIKKILINENI Member 202-306-2472 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology |
| Enumeration Date | 2025-09-03 |
| Last Update Date | 2025-09-03 |