| NPI | 1508345091 |
|---|---|
| Doing Business As | GEM STATE DERMATOLOGY |
| Entity Type | Organization |
| Authorized Contact | JEFFREY QUEEN Owner 561-314-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2018-08-07 |