| NPI | 1043666415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY CARPENTER Office Manager 561-807-8552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: FL ME116999) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME31479) |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2016-05-04 |