| NPI | 1316168339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANUS KULPA Owner 228-875-1599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS ME14877) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MS PA00086) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2010-01-26 |