| NPI | 1932630563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON LEE MUSSMAN Plastic Surgeon 989-255-4794 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: AZ 49090) |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2017-04-19 |