| NPI | 1962837815 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK PATINO Medical Director 734-207-9999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MI 4301051672) |
| Enumeration Date | 2013-09-11 |
| Last Update Date | 2016-01-28 |