| NPI | 1083707079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FERMIN ANO President 386-761-5682 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME0020477) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME0029894) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2007-09-10 |