| NPI | 1154664688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE THERESE CRUM Administrator 248-240-5699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2023-04-13 |