| NPI | 1912044611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE GILBERT JOHNSON Physician 586-771-0290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MI 5101007447) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2020-08-22 |