| NPI | 1245633411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AQUARIUS BOUIER Manager 248-967-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MI 5101007369) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MI 5101012320) |
| Enumeration Date | 2014-10-02 |
| Last Update Date | 2015-06-23 |