| NPI | 1184245284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA MENDOZA Manager 248-937-0212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2020-04-29 |
| Last Update Date | 2020-11-19 |