| NPI | 1992261481 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | KEVIN KACHAN Manager/Authorized Offical 248-250-3393 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology | 
| Enumeration Date | 2019-02-20 | 
| Last Update Date | 2022-09-16 |