| NPI | 1053647131 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA EVANS Billing/Credentialing 248-476-6385 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 023784) |
| Enumeration Date | 2009-10-26 |
| Last Update Date | 2010-06-03 |