NPI | 1780454587 |
---|---|
Entity Type | Organization |
Authorized Contact | MATTHEW DENOTTER Owner 248-894-7024 |
Organization Subpart ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner |
Additional Taxonomies | 261Q00000X Clinic/Center |
Enumeration Date | 2024-01-03 |
Last Update Date | 2024-01-03 |