| NPI | 1700136520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE SUSIN Business Manager 248-892-0715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 1784233) |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2012-09-19 |