| NPI | 1972779601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNDA HASSAN Office Manager 248-541-8554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: MI HW059778) |
| Enumeration Date | 2008-05-02 |
| Last Update Date | 2008-06-05 |