| NPI | 1730575549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MENCIA GOMEZ Md 754-210-5359 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME121955) |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2015-04-08 |