| NPI | 1194115402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SRINIVAS KONERU Md 586-574-0890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: MI 4301080674) |
| Enumeration Date | 2015-01-26 |
| Last Update Date | 2015-01-26 |