NPI | 1396182630 |
---|---|
Entity Type | Organization |
Authorized Contact | SANDY WALDRON Credentialing Contact 561-300-6909 |
Organization Subpart ? | No |
Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine |
Enumeration Date | 2013-05-28 |
Last Update Date | 2016-01-14 |