| NPI | 1003095274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCY MONTEJO Account Manager 772-467-0348 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME55755) |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2012-01-25 |