| NPI | 1194321075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARENCE WILLIAM BROWN CEO, President 269-985-0021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Enumeration Date | 2020-12-07 |
| Last Update Date | 2020-12-07 |