| NPI | 1417291790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE V MAYRIN Owner 267-242-0028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2012-12-18 |