| NPI | 1447661715 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY C LU Credentialing Coordinator 904-221-2535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 28979) |
| Enumeration Date | 2014-05-08 |
| Last Update Date | 2014-05-08 |