| NPI | 1043555774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEOPOLDO M MUNIZ Owner/Physician 803-642-3505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 21000) |
| Enumeration Date | 2012-12-06 |
| Last Update Date | 2012-12-06 |