NPI | 1205625985 |
---|---|
Entity Type | Organization |
Authorized Contact | HILLERY DOLFORD Owner 843-992-2754 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
Enumeration Date | 2025-05-01 |
Last Update Date | 2025-05-01 |