| NPI | 1487827416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER DAVID EWANOWSKI Medical Director 813-321-1786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: FL ME100378) |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2019-03-01 |