NPI | 1386021582 |
---|---|
Entity Type | Organization |
Authorized Contact | JULIE TATKO CEO 231-745-5057 |
Organization Subpart ? | Yes |
Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine |
Additional Taxonomies | 207R00000X Internal Medicine |
Enumeration Date | 2015-04-27 |
Last Update Date | 2024-06-04 |