| NPI | 1083753479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY G FABAZ Owner 231-843-2600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MI 5101006766) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2009-06-18 |