| NPI | 1336643881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA MONIQUE HALBEISEN Phyisican 734-972-5533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: CA 20A12902) |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2018-03-20 |