| NPI | 1205512480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FEDERICO JAVIER YANQUEZ President 734-659-6268 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 2086S0129X |
| Enumeration Date | 2023-06-23 |
| Last Update Date | 2025-05-30 |