| NPI | 1740383348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEIRDRE WOOD Owner 267-731-1333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2014-02-19 |