| NPI | 1265633416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI FEDORONKO President 248-362-0222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology Procedural Dermatology (Licence: MI LF064064) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2016-07-01 |