| NPI | 1538500988 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAVITHA REDDY Owner 617-872-4652 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: MA 243807) |
| Enumeration Date | 2013-07-15 |
| Last Update Date | 2013-07-15 |