| NPI | 1396145264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASAD EHTISHAM Owner 623-300-3684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology |
| Enumeration Date | 2014-08-28 |
| Last Update Date | 2020-10-20 |