| NPI | 1174719025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHENIE LUCAS Owner 313-885-2334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
| 207RI0200X Internal Medicine, Infectious Disease | |
| Enumeration Date | 2007-09-24 |
| Last Update Date | 2017-05-04 |