| NPI | 1548690092 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAFWAN KAZMOUZ Owner/Provider 734-718-0196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NH 14925) |
| Enumeration Date | 2013-11-20 |
| Last Update Date | 2024-08-01 |