| NPI | 1306091376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS MOSS Member 229-259-0032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease |
| 2086S0129X Surgery, Vascular Surgery | |
| Enumeration Date | 2008-11-18 |
| Last Update Date | 2012-05-21 |