| NPI | 1275022519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHETHANA GOTTAM Owner / Authorized Official 248-342-7627 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MI 4301108548) |
| Enumeration Date | 2018-05-02 |
| Last Update Date | 2024-11-22 |