| NPI | 1972808806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PREDRAG V GLIGOROVIC Owner 208-233-8344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ID M-9600) |
| Enumeration Date | 2011-01-25 |
| Last Update Date | 2011-01-25 |