| NPI | 1801925201 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | WILLIAM P PENN Owner 734-425-0500 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101005940) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101004910) | 
| Enumeration Date | 2007-03-04 | 
| Last Update Date | 2009-06-08 |