| NPI | 1760076251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GOLNOSH SHARAFSALEH Owner 248-219-8950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine |
| Additional Taxonomies | 207QG0300X Family Medicine Geriatric Medicine |
| Enumeration Date | 2021-02-24 |
| Last Update Date | 2021-02-24 |