| NPI | 1912079211 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY KRZYSIK Office Manager 586-939-3020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI DC005678) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2020-08-22 |