| NPI | 1184430258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANTE L JACKSON Project Lead 267-207-7303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) |
| Additional Taxonomies | 207RA0002X Internal Medicine, Adult Congenital Heart Disease |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2024-12-04 |
| Last Update Date | 2024-12-04 |