| NPI | 1508188491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE T BASSETT Program Manager 313-745-4123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MI 6315024455) |
| Enumeration Date | 2010-02-19 |
| Last Update Date | 2010-02-19 |