| NPI | 1225204118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNE T CRADDOCK Billing Manager 248-267-5005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MI SR048582) |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2008-05-01 |