| NPI | 1912157231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA M MALANDRUCCO Lead Biller 248-853-2223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301041887) |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2009-10-16 |