NPI | 1508580523 |
---|---|
Entity Type | Organization |
Authorized Contact | PETERSON GO President 909-236-0338 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice |
Additional Taxonomies | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry |
Enumeration Date | 2022-10-03 |
Last Update Date | 2022-10-03 |