| NPI | 1871243931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE ANTOSIEK Owner 586-630-6551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2022-03-23 |
| Last Update Date | 2022-07-25 |