| NPI | 1023549292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN C FREEMAN Physician Coordinator 251-414-5900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: AL 13943) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2017-03-21 |