| NPI | 1336362367 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YAN NAROSOV Office Administrator 469-621-0800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2020-08-22 |