| NPI | 1386674554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON BROWNE Member 810-229-8511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301081064) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301081546) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2020-08-22 |