| NPI | 1407375991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL CLARK TRASK General Partner 843-524-2001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC MD26623) |
| Additional Taxonomies | 207QB0002X Family Medicine, Bariatric Medicine (Licence: SC MD26623) |
| Enumeration Date | 2017-09-15 |
| Last Update Date | 2022-07-21 |