| NPI | 1689777252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE P POLETES Owner 517-485-3583 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MI GP069777) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: MI GP069777) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2013-08-20 |