| NPI | 1831110774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA M KNOBLOCK Office Manager 586-263-7200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| 207ND0900X Dermatology, Dermatopathology | |
| 207NS0135X Dermatology, Procedural Dermatology | |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2007-08-06 |