| NPI | 1336322528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERNON DENCKLAU Owner 810-989-6113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MI 5101007542) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MI 5101007542) |
| Enumeration Date | 2007-12-11 |
| Last Update Date | 2008-08-11 |