| NPI | 1730717943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA A ELLIOTT COO 734-327-0872 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2020-04-01 |