| NPI | 1275718850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA ROOD Sr It Syst EMS Analyst 234-312-5193 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2008-01-02 |
| Last Update Date | 2023-07-25 |