| NPI | 1003989690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY RATOWSKI Director Of Provider Affairs 248-703-2003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 830190) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology | |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2024-03-14 |