| NPI | 1144314154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA ROOD Sr It Syst EMS Analyst 234-312-5193 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207V00000X Obstetrics & Gynecology | |
| 2086S0122X Surgery Plastic and Reconstructive Surgery | |
| 363L00000X Nurse Practitioner | |
| 364S00000X Clinical Nurse Specialist | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2023-06-22 |