NPI | 1386846160 |
---|---|
Entity Type | Organization |
Authorized Contact | ASHWIN N RAVAL Doctor 734-285-5280 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MI 035652) |
Enumeration Date | 2007-06-04 |
Last Update Date | 2020-08-22 |