| NPI | 1063994705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY LEWIS Director Of Operations 667-240-3043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology |
| Additional Taxonomies | 174400000X Specialist |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology | |
| 246ZE0500X Specialist/Technologist, Other, EEG | |
| 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic | |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2018-08-29 |