| NPI | 1538203153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ILIGINO FERNANDEZ SALON President 304-252-8541 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV 9646) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2020-08-22 |