| NPI | 1407015795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KOTHEGALA PUTTANNIAH JAGADISH President 248-333-9556 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MI 4301043330) |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2008-11-13 |