| NPI | 1821481912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRVIN BASIL KELLER Sole Proprietor 772-569-9611 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME19360) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: FL ME19360) |
| Enumeration Date | 2015-03-12 |
| Last Update Date | 2023-03-07 |