| NPI | 1033389606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMAD KHANSA Physician Owner 313-581-2121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MI 4301062443) |
| Enumeration Date | 2008-03-10 |
| Last Update Date | 2008-09-11 |