| NPI | 1881658243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEN T TAKEGAMI President 931-455-7400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TN MD0000021099) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TN MD0000021099) |
| 207ND0900X Dermatology, Dermatopathology (Licence: TN MD0000021099) | |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2009-12-03 |