| NPI | 1861565996 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GHEORGHE PUSTA Executive Director 512-628-0465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2023-04-10 |