| NPI | 1518011386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA KAY GOMES Billing Manager 866-420-4254 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME71027) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME79013) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME79013) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL me71027) | |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2020-08-22 |