| NPI | 1124649710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROXANE CHERYL WILTSHIRE Credentialing Manager 239-224-3159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine Medical Oncology |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207RH0000X Internal Medicine Hematology | |
| Enumeration Date | 2020-05-05 |
| Last Update Date | 2020-05-05 |