| NPI | 1679739122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FANNY AGUIRRE DELA CRUZ Administrative Director 734-744-8560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: MI 36977) |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2014-08-06 |