| NPI | 1962016360 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCOS YASSA Pa C 248-629-7497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2020-09-02 |
| Last Update Date | 2020-12-16 |