| NPI | 1437794112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAHIR ELDER Authorized Official 313-993-7777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2019-11-17 |
| Last Update Date | 2019-11-22 |