| NPI | 1104434075 |
|---|---|
| Other Name | INNOVATIVE NEUROLOGY |
| Entity Type | Organization |
| Authorized Contact | JANICE RAQUEL FUENTES Authorized Official 619-306-1127 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology |
| Enumeration Date | 2020-07-16 |
| Last Update Date | 2021-02-15 |