| NPI | 1295216695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW LEITZKE Member 302-367-8765 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 111N00000X Chiropractor |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| Enumeration Date | 2018-08-23 |
| Last Update Date | 2019-02-22 |