| NPI | 1871514927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR G MELLUL Sole Proprietor 856-429-9009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NJ 25MA04514400) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2010-07-08 |