| NPI | 1508294083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DMITRIY SIVTSOV President 858-230-7585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: CA A88348) |
| Enumeration Date | 2013-10-21 |
| Last Update Date | 2024-03-13 |