| NPI | 1164096780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN MCNERNEY Practice Adminstrator 145-029-7712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2021-05-18 |
| Last Update Date | 2022-12-28 |