| NPI | 1386243178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALI ALI Owner 313-656-4014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2020-10-22 |
| Last Update Date | 2024-11-08 |