| NPI | 1114055712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEGGY N MCQUEEN Office Manager 501-202-1664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: AR 5B415) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2009-02-07 |