| NPI | 1609176817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL A ELLIOTT Owner 772-288-6300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Additional Taxonomies | 174400000X Specialist (Licence: FL OS6351) |
| 174400000X Specialist | |
| Enumeration Date | 2010-10-22 |
| Last Update Date | 2020-10-14 |