| NPI | 1154650372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BHANU (BONNIE) PASUPULETI Off Mang. 810-230-7770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Enumeration Date | 2009-12-17 |
| Last Update Date | 2010-04-12 |