| NPI | 1558441162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER W SIMONEAUX President/Owner 985-845-1674 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: LA 018423) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: LA 018423) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2007-10-31 |