| NPI | 1972529865 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARYANN G LEONARD Practice Manager 207-795-7540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: ME 016653) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2021-12-13 |