| NPI | 1508567256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA MIDDLETON Credentialing 989-321-8918 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Enumeration Date | 2023-03-10 |
| Last Update Date | 2023-08-07 |