| NPI | 1841831450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER BATCHEV Authorized Official 734-379-0016 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 202K00000X |
| Enumeration Date | 2019-10-04 |
| Last Update Date | 2019-12-06 |