| NPI | 1699945626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ENID F BURNETT Doctor 386-253-2070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: FL ME0072841) |
| Enumeration Date | 2008-03-05 |
| Last Update Date | 2008-07-03 |