| NPI | 1619605078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANE ALEXANDER NEIDIG Managing Member 410-216-0993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| 207ND0900X Dermatology, Dermatopathology | |
| 207NP0225X Dermatology, Pediatric Dermatology | |
| 207NS0135X Dermatology, Procedural Dermatology | |
| Enumeration Date | 2022-08-12 |
| Last Update Date | 2024-12-03 |