| NPI | 1194774752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID LOPEZ Director Of Physician Services 810-606-5893 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| 208000000X Pediatrics | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine | |
| 2086S0129X Surgery, Vascular Surgery | |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2024-06-12 |