| NPI | 1922711696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL RENEE LEE Medical Director 248-559-1911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2022-12-27 |
| Last Update Date | 2023-06-05 |