| NPI | 1821155169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE ANNE ALLEN Medical Biller 313-565-4010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MI 4301058685) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2008-01-15 |