| NPI | 1215182787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DINESH NAYAK Resident Agent 313-575-4988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2008-11-24 |
| Last Update Date | 2008-11-24 |