| NPI | 1316104375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELSIE MARIE SHAW Medical Student 810-441-4941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI pending) |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2008-05-19 |