| NPI | 1457973315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODY HUNTER Director Of Operations 734-812-0996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2020-05-14 |
| Last Update Date | 2020-05-14 |