| NPI | 1205220332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALI ABDULHUSSAIN Owner 313-804-0232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MI a134048000749) |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2015-03-26 |