| NPI | 1962955625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEQUINDRA QUINN Owner 313-744-2164 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704205118) |
| Enumeration Date | 2016-07-29 |
| Last Update Date | 2016-07-29 |