| NPI | 1972904951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIMMY C HAOUILOU Sole Member 586-270-5100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: MI 4301084691) |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2015-05-18 |