| NPI | 1790069714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY RATOWSKI Director Of Provider Affairs 248-703-2003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery |
| Enumeration Date | 2011-10-10 |
| Last Update Date | 2024-04-16 |