| NPI | 1356580567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB A SAMANDER Owner 772-905-8531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME0063339) |
| Enumeration Date | 2009-02-11 |
| Last Update Date | 2009-07-29 |