| NPI | 1023384708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRAMOTE TANSWAI Physician/ President Of An Organiza 248-690-7093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: MI 4301033656) |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2012-04-18 |