| NPI | 1205343225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EHTESHAM E ANSARI Program Director 586-506-1996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2017-12-30 |
| Last Update Date | 2022-04-18 |