| NPI | 1023796307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE HALL Owner 855-743-2247 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
| Enumeration Date | 2023-07-07 |
| Last Update Date | 2023-07-13 |