| NPI | 1679970958 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | DENISE GAYE HARTUNG Practice Manager 313-498-2470  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301026998)  | 
| Enumeration Date | 2014-12-02 | 
| Last Update Date | 2014-12-03 |