| NPI | 1346304748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA VENNARD Administrator 586-445-2911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology |
| Additional Taxonomies | 173000000X Legal Medicine |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2020-05-07 |