| NPI | 1851916209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERNESTO ALONSO Owner 386-288-5311 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084N0600X |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology |
| 293D00000X Physiological Laboratory | |
| Enumeration Date | 2020-06-11 |
| Last Update Date | 2020-06-24 |