| NPI | 1164877692 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYANT T ITTIARA President 734-604-0017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MI 5101017919) |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2017-03-16 |