NPI | 1083241988 |
---|---|
Entity Type | Organization |
Authorized Contact | CHRISTOPHER LEE TAICHER Chief Executive Officer And Cmo 857-210-3635 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice |
Additional Taxonomies | 101Y00000X Counselor |
103T00000X Psychologist | |
133N00000X Nutritionist | |
207Q00000X Family Medicine | |
207R00000X Internal Medicine | |
208000000X Pediatrics | |
208800000X Urology | |
Enumeration Date | 2020-03-23 |
Last Update Date | 2020-03-23 |