| NPI | 1447828561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIK ILYAYEV Owner 786-802-5942 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 103T00000X Psychologist |
| 207Q00000X Family Medicine | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 208VP0000X Pain Medicine, Pain Medicine | |
| Enumeration Date | 2021-06-15 |
| Last Update Date | 2023-07-24 |