| NPI | 1154660090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK THOMAS Sole Member 803-773-1379 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: SC 19357) |
| Enumeration Date | 2013-02-13 |
| Last Update Date | 2013-02-13 |