| NPI | 1750646428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL LAWRENCE SHELLING Owner & Sole Proprietor 561-715-4666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME111217) |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2012-07-09 |