| NPI | 1508216466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUPO CARLOTA President 901-821-8595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 2084P2900X Psychiatry & Neurology, Pain Medicine |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2016-06-21 |