| NPI | 1376094615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GIZATCHEW KETSELA Owner 850918-240-5850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME99953) |
| Enumeration Date | 2016-10-21 |
| Last Update Date | 2016-11-07 |