| NPI | 1114333853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID JOHNSON Md 855-689-5105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2020-03-03 |