| NPI | 1104814714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENE E KUNHARDT Authorized Official / Md 727-842-9486 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2018-03-09 |