| NPI | 1134438476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHALED A MOUSTAFA President 616-717-8642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101243031) |
| Enumeration Date | 2010-10-05 |
| Last Update Date | 2011-03-09 |