| NPI | 1184398067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIZ BECHARD Authorized Official 248-797-9166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2021-08-04 |
| Last Update Date | 2021-10-18 |