NPI | 1245751403 |
---|---|
Entity Type | Organization |
Authorized Contact | THOMAS J BRAZA President 910-640-0899 |
Organization Subpart ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NC 2012-00516) |
Enumeration Date | 2017-06-28 |
Last Update Date | 2021-11-01 |