| NPI | 1104558287 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSSAN SALAS Owner 734-855-4358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 207T00000X Neurological Surgery |
| Enumeration Date | 2022-06-28 |
| Last Update Date | 2022-08-24 |