| NPI | 1063767655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA L RUSHLOW Practice Manager 810-606-7739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: MI 4704155625) |
| Enumeration Date | 2012-07-19 |
| Last Update Date | 2012-07-19 |