| NPI | 1770752495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICKIE HARDAWAY Owner 313-342-2576 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301061729) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301061729) |
| Enumeration Date | 2008-02-27 |
| Last Update Date | 2008-04-29 |