| NPI | 1528398500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DON LUM President 870-541-0400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: AR C4730) |
| Enumeration Date | 2010-01-13 |
| Last Update Date | 2010-01-13 |