| NPI | 1003923707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY GRECO Payer Enrollment Manager 223-341-8516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207RC0200X Internal Medicine, Critical Care Medicine | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2025-07-31 |