| NPI | 1043382591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELIPE VIDELA Owner 810-733-0710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301029345) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2007-11-15 |