| NPI | 1740794312 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRENE LYNN MARTIN Biller 734-675-4273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301039936) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MI 4301039936) |
| Enumeration Date | 2017-11-19 |
| Last Update Date | 2017-11-19 |