| NPI | 1336997949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN GIBSON VP, Finance 304-598-4256 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2024-05-08 |
| Last Update Date | 2024-05-08 |