| NPI | 1407012701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYLVAN M WALLER President 800-893-9698 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2008-08-06 |
| Last Update Date | 2010-09-17 |