| NPI | 1467644344 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY J BUCKEL President 317-889-7546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: IN 01022110) |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2024-03-21 |