| NPI | 1952687832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATA BANSAL M.D. 407-228-0220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME58038) |
| Enumeration Date | 2011-10-24 |
| Last Update Date | 2016-01-25 |