| NPI | 1962061440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN BIGBIE Managing Member 405-701-9089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2019-06-10 |