| NPI | 1831951920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR COSCARELLI Authorized Official 734-245-9892 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology |
| Enumeration Date | 2024-01-25 |
| Last Update Date | 2025-03-07 |