| NPI | 1114386869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIANNE T CARROLL Physicain / Owner 248-891-3763 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL OS9775) |
| Enumeration Date | 2016-02-22 |
| Last Update Date | 2016-02-22 |