| NPI | 1275144586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE BLASE Owner 248-626-6500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology |
| Enumeration Date | 2020-08-11 |
| Last Update Date | 2020-08-11 |