| NPI | 1649542689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARAH KATHERINE MALICK Physician 248-743-9330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MI 4301083995) |
| Enumeration Date | 2012-02-07 |
| Last Update Date | 2012-04-25 |