| NPI | 1437798568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRAYLING LOVE C.O.O. 678-216-2718 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology |
| 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology | |
| 207NP0225X Dermatology, Pediatric Dermatology | |
| 207NS0135X Dermatology, Procedural Dermatology | |
| 207Y00000X Otolaryngology | |
| 207YS0123X Otolaryngology, Facial Plastic Surgery | |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck | |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery | |
| 208200000X Plastic Surgery | |
| Enumeration Date | 2020-01-06 |
| Last Update Date | 2020-01-06 |