| 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 |