| NPI | 1942539598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEONARD ELLISON Owner 313-342-9255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301068024) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301058406) |
| 207R00000X Internal Medicine (Licence: MI 4301053315) | |
| 207R00000X Internal Medicine (Licence: MI 4301066816) | |
| 208000000X Pediatrics (Licence: MI 4301053315) | |
| Enumeration Date | 2009-12-10 |
| Last Update Date | 2010-06-01 |