| NPI | 1710201546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA L GMITTER Owner 561-362-0510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME0056717) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: FL ME0056717) |
| Enumeration Date | 2010-03-23 |
| Last Update Date | 2010-03-23 |