| NPI | 1194428425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE GO Board President 425-259-0966 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 208000000X Pediatrics |
| 207R00000X Internal Medicine | |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2023-03-24 |
| Last Update Date | 2024-04-08 |