| NPI | 1174251078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANNA WILLIAMS CEO 248-915-8986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 207N00000X Dermatology |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2022-08-10 |
| Last Update Date | 2024-04-12 |