| NPI | 1346549409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR O UBOM Owner 248-557-8800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MI 5101007418) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704217515) |
| 363L00000X Nurse Practitioner (Licence: MI 4704154415) | |
| 363L00000X Nurse Practitioner (Licence: MI 4704248242) | |
| Enumeration Date | 2011-03-15 |
| Last Update Date | 2011-10-18 |