| NPI | 1275116881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOVIE WHEELER Manager 248-629-0448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2021-05-01 |
| Last Update Date | 2024-03-08 |