| NPI | 1285828095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENE S GIBSON Office Manager 248-431-8592 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301065590) |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2010-10-27 |