| NPI | 1598179954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE MASCIA Admin 248-955-9949 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207V00000X Obstetrics & Gynecology | |
| 207QS0010X Family Medicine, Sports Medicine | |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2023-10-23 |