| NPI | 1992734669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUNIUS BLAKE GOSLEN President 704-375-6766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2020-08-22 |