| NPI | 1093941908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAHROKH MANSOORI Owner 248-844-2980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MI SM038518) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI AM076045) |
| 207R00000X Internal Medicine (Licence: MI NM074148) | |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2012-01-09 |