| NPI | 1285406249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES MINN Md 855-621-8250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology |
| Additional Taxonomies | 163WD1100X Registered Nurse, Dialysis, Peritoneal |
| 163WH0500X Registered Nurse, Hemodialysis | |
| 2472R0900X Technician, Other, Renal Dialysis | |
| 332BD1200X Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies | |
| Enumeration Date | 2023-10-24 |
| Last Update Date | 2023-11-10 |