| NPI | 1881220069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA LYNN BRAXTON Owner 248-225-7927 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 133N00000X Nutritionist | |
| 133V00000X Dietitian, Registered | |
| Enumeration Date | 2020-03-19 |
| Last Update Date | 2020-04-14 |