| NPI | 1699136655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS M PROSE President 248-662-0250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2016-03-17 |
| Last Update Date | 2021-03-19 |