| NPI | 1962625533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RITCHIE OLIVER ROSSO Physician 757-650-6954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology |
| Additional Taxonomies | 174400000X Specialist (Licence: TX E2507) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2018-03-01 |