| NPI | 1962091264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEDA GERSTL Credentialing Coordinator 702-589-4871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2021-01-12 |
| Last Update Date | 2021-03-04 |