| NPI | 1811945199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS MARK PROSE President 248-662-0250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2015-09-16 |