| NPI | 1801128657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM D MACINNES Member 989-921-5100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MI 6301008040) |
| Enumeration Date | 2010-02-04 |
| Last Update Date | 2017-11-22 |