| NPI | 1023323029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA L SANDIFER Owner 601-948-5158 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MS 20965) |
| Enumeration Date | 2010-08-13 |
| Last Update Date | 2010-08-13 |