| NPI | 1245651983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUTH SHIELDS Member 251-533-0224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QB0002X Family Medicine, Bariatric Medicine (Licence: AL 4527) |
| Enumeration Date | 2013-12-24 |
| Last Update Date | 2013-12-24 |