| NPI | 1285993337 |
|---|---|
| Doing Business As | DIMITRI DERMATOLOGY |
| Entity Type | Organization |
| Authorized Contact | KAREN RACHEL DRAKE Credentialing Coordinator 985-643-4512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: LA 14885R) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MS 21866) |
| Enumeration Date | 2012-05-10 |
| Last Update Date | 2012-05-10 |