| NPI | 1700176849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON R. MICHAELS Manager 401-239-1800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: RI MD13562) |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2021-11-04 |