NPI | 1891119566 |
---|---|
Entity Type | Organization |
Authorized Contact | ABDELKADER H FARES Doctor 313-843-1973 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MI AF04301043357) |
Enumeration Date | 2014-02-14 |
Last Update Date | 2014-02-14 |