| NPI | 1972856714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMIKA MARQUITTA BURRUS President 323-913-4350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology Vascular Neurology |
| Enumeration Date | 2012-10-17 |
| Last Update Date | 2012-10-17 |