| NPI | 1447420070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OZ IDLIBI Administrator 803-393-3710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 174400000X Specialist (Licence: SC 06954) |
| Enumeration Date | 2008-03-11 |
| Last Update Date | 2022-11-14 |