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 |