| NPI | 1215058342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUMANA ANIS BARODAWALLA Medical Director 989-772-7774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301068018) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2020-08-22 |