| NPI | 1588034409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMIL SIDHU Owner 866-805-8005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2015-10-05 |
| Last Update Date | 2017-03-16 |