| NPI | 1245311869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA R BOLTON President 248-816-1420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: MI 4301043268) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2020-08-22 |