| NPI | 1699210401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY ANDREW GORDON Owner 601-214-3539 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MS 16391) |
| Enumeration Date | 2017-01-03 |
| Last Update Date | 2017-01-03 |