| NPI | 1003833179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINA M. MUSIC Director Provider Enrollment 877-892-9815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208M00000X Hospitalist | |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2025-06-11 |