| NPI | 1861215907 |
|---|---|
| Doing Business As | KETAMINE HAVEN CLINIC |
| Entity Type | Organization |
| Authorized Contact | REZA BORNA Proprietor 747-836-3803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Enumeration Date | 2024-11-06 |
| Last Update Date | 2024-11-06 |