NPI | 1326675075 |
---|---|
Entity Type | Organization |
Authorized Contact | KARYN RAE Chief 843-876-1344 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 208000000X Pediatrics |
207R00000X Internal Medicine | |
Enumeration Date | 2020-03-24 |
Last Update Date | 2020-03-24 |