| NPI | 1649476532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD SHERMAN Owner 386-673-5969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: FL OS4000) |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2020-08-22 |