| NPI | 1104629732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VISHNU PEMMARAJU Owner 248-635-5038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery |
| Additional Taxonomies | 208600000X Surgery |
| Enumeration Date | 2025-03-29 |
| Last Update Date | 2025-03-29 |