| NPI | 1710926670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT WINSTON GILLUM Physican 313-831-3066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI 007845) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2007-11-07 |