| NPI | 1740280676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT GORDON Owner/Physician 734-455-2970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: MI RG008180) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2020-08-22 |