NPI | 1457496952 |
---|---|
Entity Type | Organization |
Authorized Contact | VICENTE D CABANSAG President 269-651-9302 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301080148) |
Additional Taxonomies | 208600000X Surgery (Licence: MI 033706) |
208D00000X General Practice (Licence: MI 033706) | |
Enumeration Date | 2007-02-21 |
Last Update Date | 2010-01-27 |