| NPI | 1225582687 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TALISHA WATTS CEO 313-465-9892 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WG0000X Registered Nurse, General Practice (Licence: MI 4704246644) |
| Enumeration Date | 2016-08-15 |
| Last Update Date | 2016-08-15 |