| NPI | 1396866281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISABELLE PONGE WILSON Doctor 212-679-4134 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: NY 198244) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 198244) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 198244) | |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2013-01-03 |