| NPI | 1336707231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA ROOD Sr Systems Analyst 234-312-5193 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2019-06-05 |