| NPI | 1407039050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS JOSEPH VIVIANO CEO 985-893-9464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: LA 015859) |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2007-12-05 |