| NPI | 1700666708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW DENOTTER Owner 248-894-7024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care |
| 207R00000X Internal Medicine | |
| 208600000X Surgery | |
| Enumeration Date | 2023-10-05 |
| Last Update Date | 2024-09-16 |