| NPI | 1225564271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAHAR HASSANE Manager 586-598-8115 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301102602) |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-11-03 |