| NPI | 1063086601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAJAN RAO Owner 239-963-9788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2021-05-18 |
| Last Update Date | 2023-07-28 |