| NPI | 1740945872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE NOVAK Member 586-219-7058 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine |
| Enumeration Date | 2021-11-03 |
| Last Update Date | 2021-11-03 |