| NPI | 1861575789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA MARIE GREEN Physician 313-833-5032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5101009317) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2020-08-22 |