NPI | 1295448603 |
---|---|
Entity Type | Organization |
Authorized Contact | CAITLIN ROBINSON Owner 318-547-8055 |
Organization Subpart ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
Enumeration Date | 2022-12-30 |
Last Update Date | 2023-05-22 |