| NPI | 1497291124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILSON BARTON EDWARDS Owner 850-250-3360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: FL ME65288) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology Forensic Psychiatry (Licence: FL ME65288) |
| Enumeration Date | 2017-01-19 |
| Last Update Date | 2017-03-15 |