| NPI | 1497847917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALANNA N BLACK Office Manager 228-818-9008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine Nephrology (Licence: MS 15918) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2020-08-22 |