NPI | 1417644873 |
---|---|
Entity Type | Organization |
Authorized Contact | IAN DAVID GREGORY Chief Accession Medical Waiver Div 210-652-9205 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Enumeration Date | 2023-04-18 |
Last Update Date | 2023-04-18 |