| NPI | 1740912062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ESTELLA ROHM Clinical Coordinator 231-672-8289 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2022-06-27 |
| Last Update Date | 2022-06-27 |