| NPI | 1568992782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAFFAELE PENNELLA Physician/Owner 417-889-3332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: MO 110288) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2022-07-21 |