| NPI | 1932582111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAITH STEWART Owner 678-488-1673 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX N9307) |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2015-07-07 |