| NPI | 1093913204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE DAWN NEIDER Doctor 231-398-1700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 173000000X Legal Medicine (Licence: MI 4301086785) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2012-02-10 |