| NPI | 1912298902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY OWENS Credentialing 734-459-7444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI CG033015) |
| Enumeration Date | 2011-04-25 |
| Last Update Date | 2018-06-20 |