| NPI | 1679631360 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN DENHARDT Practice Manager 248-847-3210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: MI 4301085240) |
| Additional Taxonomies | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: MI 4301026037) |
| 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: MI 5101010352) | |
| 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: MI 5101009481) | |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2016-05-18 |