| NPI | 1790819001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL G. MOORE Administrator 313-745-8212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2020-08-22 |