| NPI | 1902417249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC ANGEME AMENE Owner 443-803-4837 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2020-08-11 |
| Last Update Date | 2020-10-30 |