| NPI | 1356778898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN DREW GROSS Director 904-437-5176 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: FL PY 8505) |
| Enumeration Date | 2013-09-30 |
| Last Update Date | 2019-06-21 |