| NPI | 1710599535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TWANA L JOHNSON Ap RN 734-837-3967 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2020-08-21 |
| Last Update Date | 2021-08-11 |