| NPI | 1639551781 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN RICHARDSON Owner 716-361-6017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX P0479) |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2015-06-25 |