| NPI | 1669607966 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN L TALOS Authorized Official 248-935-5571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME103440) |
| Enumeration Date | 2009-05-16 |
| Last Update Date | 2009-05-16 |