| NPI | 1902672652 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN SOFEN Owner 248-563-2489 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Enumeration Date | 2023-12-04 |
| Last Update Date | 2023-12-04 |