| NPI | 1285719286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANNE MCKINNON Office Manager 586-421-1740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2020-06-17 |