| NPI | 1538670518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA LEE HUISMAN Office Manager 810-990-8222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MI 4301055094) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MI 430107244) |
| Enumeration Date | 2017-10-18 |
| Last Update Date | 2020-12-29 |