| NPI | 1396051348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT SCOTT ROTH Medical Director 424-288-6930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: G48505) |
| Enumeration Date | 2010-08-28 |
| Last Update Date | 2011-01-05 |