| NPI | 1194901314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA J MCCOY Credentialing Specialist 605-217-2615 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IA 28247) |
| Enumeration Date | 2008-01-17 |
| Last Update Date | 2008-01-17 |