| NPI | 1871852533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAYNETTE GOUDY-EGGER Administrator 313-870-9260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 163W00000X Registered Nurse |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2012-05-15 |