| NPI | 1073542742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY CARDELLIO President 586-573-3500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MI 5101005761) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MI 5101012321) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2010-07-30 |