| NPI | 1265141444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI KOLIN Authorized Official 844-755-8102 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology |
| 208000000X Pediatrics | |
| 208D00000X General Practice | |
| Enumeration Date | 2022-11-16 |
| Last Update Date | 2025-03-06 |