| NPI | 1821797622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM NGUYET LILLY-BERNAU Nurse Practitioner / Provider 313-720-3358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2023-03-01 |
| Last Update Date | 2023-04-17 |