| NPI | 1154833887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEMA BURRILL Office Manager 386-402-7827 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME117878) |
| Enumeration Date | 2017-11-03 |
| Last Update Date | 2018-03-17 |