| NPI | 1538222823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE B LOPEZ Physician 810-715-3049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI JL047858) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI MO079826) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2010-02-09 |