| NPI | 1376718833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYMM PIETSZAK Manager 734-243-3420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2008-04-25 |