| NPI | 1225613870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABLA SOUEIDAN Credentialing Manager/Partner 313-207-5767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine |
| Enumeration Date | 2021-03-16 |
| Last Update Date | 2023-11-14 |