| NPI | 1972006047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENISE KERNER Physician/Manager 248-836-8129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MI 4301045002) |
| Enumeration Date | 2018-03-14 |
| Last Update Date | 2018-06-16 |