| NPI | 1457378036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID CHRISTOPHER MILLER President 734-936-3568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2021-05-03 |