| NPI | 1154671113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISSA FISHER Enrollment Compliance Officer 210-598-4240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology |
| Enumeration Date | 2012-09-17 |
| Last Update Date | 2017-04-19 |