| NPI | 1033327754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALIDAH NATHOO Rph 734-451-5009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: MI 5301007005) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2020-08-22 |