| NPI | 1780128314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS M PROSE President 248-662-0250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2016-12-16 |
| Last Update Date | 2016-12-16 |