| NPI | 1972527026 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THULASI S DIVI Owner/President 248-528-1555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301062122) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2009-12-14 |