| NPI | 1073992715 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD BERG Owner 586-285-5783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MI 4301041478) |
| Enumeration Date | 2015-05-27 |
| Last Update Date | 2015-06-10 |