| NPI | 1265535140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHRYN V BALAZS Practice Owner Physician 937-427-4600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2020-08-22 |