| NPI | 1417541954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMIKO L PARKS Administrator 248-798-3969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SG0600X Clinical Nurse Specialist, Gerontology |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2021-02-25 |
| Last Update Date | 2021-02-25 |