| NPI | 1366938607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY ANN BECK Practice Manager 313-769-5914 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301078352) |
| Enumeration Date | 2018-07-10 |
| Last Update Date | 2018-07-10 |