| NPI | 1780852202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JOSEPH ROGERS Owner 863-385-7183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME0058778) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: FL ME0058778) |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2008-02-19 |