| NPI | 1063819340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE GAYE HARTUNG Practice Manager 313-498-2470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301049218) |
| Enumeration Date | 2014-12-02 |
| Last Update Date | 2014-12-02 |