| NPI | 1609966670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HARDIK M SHAH President/ Owner 586-772-9055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: MI 5101010763) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2020-08-22 |