| NPI | 1306296728 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEVERIN GRENOBLE Owner 251-317-4040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: AL MD30944) |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2022-07-21 |