| NPI | 1104867910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA D BOLTON Billing Manager 734-712-0635 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: MI RN043612) |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2008-06-20 |