| NPI | 1952469587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR O UBOM Owner 248-557-8800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704217515) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704127273) |
| 363L00000X Nurse Practitioner (Licence: MI 4704154666) | |
| 363L00000X Nurse Practitioner (Licence: MI 4704170335) | |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2008-06-18 |