| NPI | 1548207467 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | KULDIP S. DEOGUN President 586-997-5048  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine | 
| Additional Taxonomies | 363L00000X Nurse Practitioner | 
| Enumeration Date | 2006-05-31 | 
| Last Update Date | 2019-01-09 |