| NPI | 1639438062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLIE GALOVICH Biller 248-593-9780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MI 5101011021) |
| Additional Taxonomies | 208VP0000X Pain Medicine Pain Medicine (Licence: MI 5101011021) |
| Enumeration Date | 2012-05-04 |
| Last Update Date | 2013-03-01 |