NPI | 1396138319 |
---|---|
Entity Type | Organization |
Authorized Contact | VIOLA JACOBS Owner 321-946-6864 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME90116) |
Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME85807) |
Enumeration Date | 2015-03-16 |
Last Update Date | 2015-03-16 |