| NPI | 1942637772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE HUGHES Physician/Owner 228-215-0669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MS 21095) |
| Additional Taxonomies | 261QM2500X Clinic/Center Medical Specialty (Licence: MS 21095) |
| Enumeration Date | 2013-10-13 |
| Last Update Date | 2013-10-23 |