| NPI | 1487388252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEMARCQUANAEE JOHNSON-PETERS Md 225-241-1119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2022-07-15 |
| Last Update Date | 2024-04-08 |