| NPI | 1235665381 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANA MAYS M.D./Owner 502-384-6544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: KY 43619) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2020-04-02 |