| NPI | 1194917641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON PATRICK JOHNSON President/CEO 907-727-9393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: AK 5036) |
| Additional Taxonomies | 2084N0600X (Licence: AK 5036) |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: AK 5036) | |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2007-11-01 |