| NPI | 1366565442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN JEUP Credentialing Specialist 248-680-8203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 630070) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2019-08-28 |