| NPI | 1336980069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA A RAGHIB Practice Manager 616-914-8894 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery |
| Enumeration Date | 2024-06-05 |
| Last Update Date | 2024-06-12 |