| NPI | 1386177251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN MICHAEL-DAVID WILKE Owner/President 760-317-5797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2018-06-20 |