| NPI | 1316522691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GOLTA RASOULI Co Presendent 941-529-0070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 202K00000X |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery | |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2021-03-17 |
| Last Update Date | 2024-10-23 |