| NPI | 1821683053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GANIU EDU Owner 313-932-1350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 208VP0000X |
| Enumeration Date | 2021-03-09 |
| Last Update Date | 2021-03-09 |