| NPI | 1518998483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE BREWER Director Of Provider Enrollment 877-892-9813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 208D00000X General Practice |
| 364S00000X Clinical Nurse Specialist | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2008-09-09 |