| NPI | 1568283414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMELITO TAVARES MORENO President 857-499-0014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2024-10-23 |
| Last Update Date | 2024-10-23 |