| NPI | 1942561428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES J SHANLEY Physician Owner 313-268-7391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: MI 4301051382) |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2012-05-31 |