| NPI | 1629493630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN L BLANK Provider 989-754-3349 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MI 4301058197) |
| Enumeration Date | 2014-02-27 |
| Last Update Date | 2014-11-04 |