NPI | 1811002710 |
---|---|
Entity Type | Organization |
Authorized Contact | TOMMI A WHITE Chief Executive Officer 734-632-0175 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 207Q00000X Family Medicine |
363A00000X Physician Assistant | |
363L00000X Nurse Practitioner | |
Enumeration Date | 2006-08-20 |
Last Update Date | 2013-12-26 |