| NPI | 1891822268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MRIDULA PRASAD Owner 219-836-0039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2020-08-22 |