| NPI | 1316374176 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVE GUPTA Physician 517-484-2261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: MI 4301102279) |
| Enumeration Date | 2013-10-10 |
| Last Update Date | 2013-10-10 |