| NPI | 1083798326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY RATOWSKI Director Office Of Provider Affairs 313-874-4806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MI 830190) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2024-08-23 |