| NPI | 1609190982 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID G SMITH Owner 440-853-8208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 202K00000X Phlebology (Licence: OH 3506461) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: OH 35064610) |
| Enumeration Date | 2010-03-16 |
| Last Update Date | 2024-05-21 |