| NPI | 1548024540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH SANTIAGO President 843-796-7422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207N00000X Dermatology |
| Enumeration Date | 2024-02-09 |
| Last Update Date | 2025-03-20 |