NPI | 1740047992 |
---|---|
Entity Type | Organization |
Authorized Contact | GINA PIERCE Practice Administrator 734-542-5512 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 207Q00000X Family Medicine |
363A00000X Physician Assistant | |
363L00000X Nurse Practitioner | |
Enumeration Date | 2024-03-04 |
Last Update Date | 2024-03-04 |