| NPI | 1134133630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOURICE DAVID Physician 231-722-6093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI 4301062227) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2018-08-09 |