| NPI | 1336126978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISHA C FALK VP Contracting 800-893-9698 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2005-12-26 |
| Last Update Date | 2016-02-16 |