| NPI | 1710304514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAZIN YALDO Owner 734-673-5917 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA 201332910064) |
| Enumeration Date | 2014-03-18 |
| Last Update Date | 2014-03-18 |