| NPI | 1659082402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN EDELMAN President 248-858-3190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology |
| Enumeration Date | 2022-12-12 |
| Last Update Date | 2022-12-12 |