| NPI | 1770765893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOREN MATTHEW WHITE Owner/President 212-396-3688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology Procedural Dermatology (Licence: NY 206357) |
| Enumeration Date | 2007-11-30 |
| Last Update Date | 2007-11-30 |