| NPI | 1972765501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL SACKMAN Owner 586-722-7498 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2024-10-10 |