| NPI | 1396837308 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | UKONU OKORO EJIE Provider 386-274-1966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME86706) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME86706) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2019-02-15 |