| NPI | 1104415124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AQEELA R MUNTAQIM Owner 313-757-2616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| Enumeration Date | 2021-01-14 |
| Last Update Date | 2021-01-14 |