| NPI | 1053527226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS P. WALDINGER Physician 313-274-5810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: MI 4301043778) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2018-03-17 |