NPI | 1376961714 |
---|---|
Entity Type | Organization |
Authorized Contact | GREGORY BYRNE President 469-401-2386 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 363A00000X Physician Assistant |
363L00000X Nurse Practitioner | |
Enumeration Date | 2014-04-02 |
Last Update Date | 2015-09-16 |