| NPI | 1538696802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODROS MENGESHA Medical Doctor 256-963-9444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2017-05-17 |
| Last Update Date | 2024-11-17 |