| NPI | 1790927234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN ANN HENEIN Np C 313-885-8589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704190384) |
| Enumeration Date | 2009-03-30 |
| Last Update Date | 2019-04-10 |