| NPI | 1972928513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALIA B PRUITT Administrative Assistant 517-455-7155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MI 5101015307) |
| Enumeration Date | 2014-02-19 |
| Last Update Date | 2014-03-25 |