| NPI | 1295818169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTIE R STAUSS Physician Services Manager 629-255-2620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2017-11-01 |