| NPI | 1528614229 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAZIA MAHMOOD Member 270-300-5564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2019-08-18 |
| Last Update Date | 2019-08-18 |