| NPI | 1093915910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY P. DERDERIAN Member 248-594-3091 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MI 5101007182) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2023-02-23 |