| NPI | 1487758983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN Z SMITH President 502-896-8803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: KY 17338) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: KY 17338) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: KY 17338) | |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2009-02-12 |