| NPI | 1528323185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONSTANCE LEE SCOTT Physician 989-797-7546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MI 5101012096MI) |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2012-07-25 |