| NPI | 1558132399 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | TAKOYA S BROWN Member 248-639-0733  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 163WG0000X Registered Nurse, General Practice | 
| Additional Taxonomies | 261Q00000X Clinic/Center | 
| Enumeration Date | 2024-01-10 | 
| Last Update Date | 2024-01-10 |