| NPI | 1306261243 |
|---|---|
| Doing Business As | INNOVATIVE DERMATOLOGY |
| Entity Type | Organization |
| Authorized Contact | MINH P THIEU President 215-605-8534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Enumeration Date | 2014-03-02 |
| Last Update Date | 2015-07-23 |