| NPI | 1902370240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA EL MASRI Credentialing COO Rdinator 248-215-0048 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2019-01-21 |
| Last Update Date | 2021-02-05 |