| NPI | 1922230416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONAS NELSON Credentialing 917-336-8422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX M8312) |
| Enumeration Date | 2009-08-17 |
| Last Update Date | 2022-12-07 |