| NPI | 1659900850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HYLAND ELIZABETH CRONIN CEO 304-685-3629 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2020-12-22 |