| NPI | 1336419670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISSAM MANSOUR Owner 248-888-9500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MI 5901002177) |
| Enumeration Date | 2012-01-04 |
| Last Update Date | 2012-06-14 |