| NPI | 1487716072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY RATOWSKI Director Of Provider Affairs 313-874-4806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MI 830190) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2024-08-23 |