| NPI | 1528189636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERNST IBO NATER Owner 248-515-1035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: MI 4301059922) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2020-08-22 |