| NPI | 1578304614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THAER JAMAL FARHAN Owner 810-652-6333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service |
| Enumeration Date | 2024-06-03 |
| Last Update Date | 2024-07-12 |