| NPI | 1093907461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT DAVID DINICK Manager 248-919-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MI 4301076963) |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2021-04-14 |