| NPI | 1689850133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SRINIVAS PULAPAKA Billing Supervisor 313-882-0640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology |
| Enumeration Date | 2008-01-15 |
| Last Update Date | 2008-01-15 |