| NPI | 1811342561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN SULE Manager 229-333-9838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 60329) |
| Enumeration Date | 2016-05-02 |
| Last Update Date | 2016-05-02 |