| NPI | 1104852300 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISHA T PATRICKCOOKS Billing Department 302-730-0554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C10005294) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE c10005391) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2010-10-27 |