| NPI | 1649240516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW ALAN GILL President Of Corporation 586-778-1881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 173000000X Legal Medicine |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2021-01-29 |