| NPI | 1386160059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LARUSSO Owner 856-816-2934 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: DE 2017605796) |
| Enumeration Date | 2017-08-15 |
| Last Update Date | 2022-07-21 |