| NPI | 1710429683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NAGAPRASADARAO MUMMANENI Physician 248-425-8880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX G4175) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A37672) |
| 207L00000X Anesthesiology (Licence: MI 4301035894) | |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2022-08-19 |