| NPI | 1245675636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH DANIEL FARR Medical Director 843-842-2020 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207ND0900X Dermatology Dermatopathology (Licence: SC MD31744) |
| Enumeration Date | 2013-04-30 |
| Last Update Date | 2013-04-30 |