| NPI | 1629642251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE BLASE Owner 248-626-6500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| Enumeration Date | 2021-05-18 |
| Last Update Date | 2021-05-18 |