| NPI | 1902199862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER IACOBELLI Sole Member 810-714-5100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301074411) |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2013-11-19 |