| NPI | 1508074212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA JUSTICE Office Manager 734-282-2500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MI 5101015449) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2020-08-22 |