| NPI | 1194754499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISHA C FALK VP Of Contracting 800-893-9698 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2016-02-18 |