| NPI | 1821329616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE KHABENSKIY Business Manager 917-836-5771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OH BR9944732) |
| Enumeration Date | 2010-01-19 |
| Last Update Date | 2010-01-19 |