| NPI | 1992206411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INNA KOGAN Md Pa 469-791-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: TX H9662) |
| Enumeration Date | 2018-02-21 |
| Last Update Date | 2018-02-21 |