| NPI | 1366888224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN BAUER Cmo 734-632-0175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2013-05-20 |
| Last Update Date | 2014-07-15 |