| NPI | 1326586942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONI GREEN Owner 313-404-3879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2017-02-02 |
| Last Update Date | 2019-04-17 |