| NPI | 1649313420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES EDWARD VICKERMAN President 610-326-2746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2020-08-22 |