| NPI | 1376029579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW LEOPOLD SMITH Vice President 239-437-0562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: FL ME74107) |
| Enumeration Date | 2018-07-11 |
| Last Update Date | 2018-07-11 |