| NPI | 1386655926 |
|---|---|
| Doing Business As | NELDAGAE S CHISA MD |
| Entity Type | Organization |
| Authorized Contact | NELDAGAE CHISA President Owner 248-647-5015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: MI 4301022545) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2020-08-22 |