| NPI | 1245319094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD J WASSERMANN Medical Director 803-779-1200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: SC 19438) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2011-10-12 |