NPI | 1104225168 |
---|---|
Entity Type | Organization |
Authorized Contact | DALE THOMPSON CFO 517-975-7555 |
Organization Subpart ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
Additional Taxonomies | 363A00000X Physician Assistant |
363L00000X Nurse Practitioner | |
207RP1001X Internal Medicine, Pulmonary Disease | |
Enumeration Date | 2014-08-15 |
Last Update Date | 2018-08-02 |