| NPI | 1558072629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMIR-KIANOOSH FALLAHI Medical Director 810-953-0500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2022-12-09 |
| Last Update Date | 2023-11-01 |