| NPI | 1710086160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARI KOSCIUSZKO Practice Manager 989-799-8712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MI 4301045222) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI 4301022285) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301072871) | |
| 363AS0400X Physician Assistant, Surgical (Licence: MI 5601001993) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2010-08-02 |