| NPI | 1336687896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLUGBEMIGA E JEGEDE Medical Director 810-908-9996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NC 211390) |
| Enumeration Date | 2017-02-05 |
| Last Update Date | 2017-02-05 |