| NPI | 1649569930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL IAN VENGROW President 866-845-4595 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2011-04-07 |