| NPI | 1841205473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEIDI M DALE Office Manager 248-644-0670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MI WV044693) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MI WV044693) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2020-08-22 |