| NPI | 1386788446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY M RUST Cnmri Authorized Representative 302-346-2491 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2025-01-15 |