| NPI | 1427810480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE THOMAS SMITH Owner 877-940-7200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2024-01-25 |
| Last Update Date | 2024-03-08 |