| NPI | 1609964543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RIAZ A NASEER Physician 618-288-5906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 3649365) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2018-01-19 |