| NPI | 1437697224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HELENE STOLLER Practice Owner 843-290-6828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: SC APN1338RX) |
| Enumeration Date | 2017-02-01 |
| Last Update Date | 2017-02-01 |