| NPI | 1376713974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PENNY GRIESE Biller 989-753-2061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2082S0105X Plastic Surgery Surgery of the Hand (Licence: MI 4301032786) |
| Enumeration Date | 2008-03-11 |
| Last Update Date | 2015-09-17 |