| NPI | 1487843199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SABRA SULLIVAN Manager 601-355-8555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: MT 14238) |
| Enumeration Date | 2007-10-18 |
| Last Update Date | 2007-10-18 |