| NPI | 1245734730 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELMOATAZ IBRAHIM CEO 612-298-1580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301094678) |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2020-11-23 |