| NPI | 1942702436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA BURT Practice Manager 313-407-1545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301080553) |
| Enumeration Date | 2018-03-01 |
| Last Update Date | 2023-08-22 |