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NPI 1275179848 · on the registry since 2019 · sole proprietor
Practice
- Address
- 21231 N Evers Pl
Ferndale, MI 48220 - Phone
- (313) 984-9464
Registry record
- Primary taxonomy
- 175T00000X
175T00000X
- Sex
- Male
- Record last updated
- 2019-11-19
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan