| NPI | 1013364041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALI ISSA SOBH Resident Physician 313-999-9650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2016-05-19 |