| NPI | 1326819574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHODONNA ANDERSON Wner 248-227-1736 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2024-01-15 |
| Last Update Date | 2024-01-15 |