| NPI | 1477872125 |
|---|---|
| Other Name | LAKESIDE NEUROLOGY |
| Entity Type | Organization |
| Authorized Contact | THOMAS WINGER Business Manager 800-416-1767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Enumeration Date | 2010-05-20 |
| Last Update Date | 2010-05-20 |