| NPI | 1316349236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLE WORTHING Physician Assistant 586-286-2770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MI 5601005798) |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2014-09-23 |