| NPI | 1912795709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIYAN MOHAMMAD RAZA Provider 989-327-4408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2025-04-30 |
| Last Update Date | 2025-04-30 |