| NPI | 1487488110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN D POLING Owner 239-293-8403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 2083B0002X Preventive Medicine, Obesity Medicine |
| Enumeration Date | 2024-08-27 |
| Last Update Date | 2024-11-07 |