| NPI | 1275171746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYED SADIQ Medical Director 228-234-9894 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology |
| Enumeration Date | 2019-12-16 |
| Last Update Date | 2025-09-11 |