| NPI | 1649570086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLIE GALOVICH Biller 248-593-9780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 5101017430) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 5101011584) |
| Enumeration Date | 2010-11-02 |
| Last Update Date | 2012-06-22 |