| NPI | 1508909128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PREMLATHA C REDDY Manager 586-791-5210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MI 034413) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2021-11-04 |