| NPI | 1174299655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONALI WILBORN Chief Clinical Officer 248-470-9509 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2021-08-17 |
| Last Update Date | 2021-08-17 |