| NPI | 1982015228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMMAD TABBAH Sole Mbr 810-399-6356 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology |
| Enumeration Date | 2014-05-08 |
| Last Update Date | 2014-05-08 |