| NPI | 1538762760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY WORTHAM Senior Credentialing COO Rdinator 033-930-7803 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology |
| Enumeration Date | 2020-11-19 |
| Last Update Date | 2023-09-21 |