| NPI | 1528007952 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE SCHAFER Executive Director 231-592-4217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208800000X Urology |
| 363A00000X Physician Assistant (Licence: MI 5601004630) | |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2022-07-21 |