| NPI | 1538761655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BISHR AL DABAGH Owner 704-230-1302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Additional Taxonomies | 207N00000X Dermatology |
| 207NS0135X Dermatology, Procedural Dermatology | |
| 207NP0225X Dermatology, Pediatric Dermatology | |
| Enumeration Date | 2020-11-13 |
| Last Update Date | 2021-01-26 |