| NPI | 1336856921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA KING Business Owner 313-765-7128 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2022-11-02 |
| Last Update Date | 2022-11-02 |