| NPI | 1881968394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEETHAYE L ITTIARA Md 517-263-5810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301031889) |
| Enumeration Date | 2012-03-01 |
| Last Update Date | 2012-03-01 |