| NPI | 1043754526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AYESHA EBRAHIM CEO 218-205-0198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2016-12-19 |
| Last Update Date | 2022-03-04 |