| NPI | 1003219411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA MARIE AJINE-BASIL Physician Assistant/Surgery 586-808-0907 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery |
| Enumeration Date | 2014-09-29 |
| Last Update Date | 2014-09-29 |