| NPI | 1720524218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VENKAT RUDRARAJU Official 248-593-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA 4301067927) |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2017-01-09 |