| NPI | 1376732388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHABBIR KHAMBATI Preident 586-792-3891 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MI SK070791) |
| Enumeration Date | 2007-10-16 |
| Last Update Date | 2008-05-06 |