| NPI | 1023029154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRYSTAL DREYER Office Manager 386-326-3633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME78625) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2015-07-16 |