NPI | 1144969114 |
---|---|
Entity Type | Organization |
Authorized Contact | DAVID WOLFF Single Member LLC 712-899-6167 |
Organization Subpart ? | No |
Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine |
Additional Taxonomies | 207Q00000X Family Medicine |
207QA0401X Family Medicine, Addiction Medicine | |
Enumeration Date | 2022-05-29 |
Last Update Date | 2022-05-29 |