| NPI | 1265207229 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLI E JOHNSTON Pediaatrician/Owner 248-760-4587 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2023-11-20 |
| Last Update Date | 2024-03-30 |