| NPI | 1336899061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLGA DEMIDOVA Director 216-280-1343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Enumeration Date | 2022-03-25 |
| Last Update Date | 2022-03-25 |