| NPI | 1427017300 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE L BENNETT President 716-631-1622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 2301181) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: NY 230118-1) |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2007-07-10 |