NPI | 1790875987 |
---|---|
Entity Type | Organization |
Authorized Contact | FAKHRE ALAM Md 618-549-6378 |
Organization Subpart ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036101704) |
Enumeration Date | 2006-10-16 |
Last Update Date | 2024-01-31 |