| NPI | 1790374015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY SAGE Billing Manager 954-815-2286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology |
| Enumeration Date | 2021-01-12 |
| Last Update Date | 2021-01-12 |