| NPI | 1972362002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIDHARTH THUMMALAPALLY Authorized Official 571-525-8048 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2024-03-19 |
| Last Update Date | 2026-05-04 |