| NPI | 1497105191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY KELLER Owner 317-215-0928 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: IN 01072313A) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2024-02-19 |