| NPI | 1609425180 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA EL MASRI Credentialing Coordinator 248-215-0048 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2019-09-08 |
| Last Update Date | 2023-04-10 |