NPI | 1891534939 |
---|---|
Entity Type | Organization |
Authorized Contact | JONATHAN W CHOLAK Practice Administrator 248-497-8721 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 363L00000X Nurse Practitioner |
Enumeration Date | 2024-05-20 |
Last Update Date | 2024-05-20 |