NPI | 1396094926 |
---|---|
Entity Type | Organization |
Authorized Contact | JACKLYN PRICE Administrator 313-908-3071 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301097600) |
Enumeration Date | 2012-08-29 |
Last Update Date | 2012-08-29 |