| NPI | 1730631037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZHANNA ZITSBANK Member 305-417-0006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY 8220) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA 9104275) |
| Enumeration Date | 2016-11-03 |
| Last Update Date | 2016-11-03 |