| NPI | 1477647303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES WILLIAM BARTHOLOME President 765-288-8188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IN 50001481A) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2007-10-18 |