| NPI | 1467429407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL C. GRATTENDICK Treasurer 561-626-5512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MA 22D0077627) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2015-09-15 |