| NPI | 1558506550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINA MUSIC Dir Prov Enrollment 877-892-9815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 207Q00000X Family Medicine | |
| 207RP1001X Internal Medicine, Pulmonary Disease | |
| 208000000X Pediatrics | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 208M00000X Hospitalist | |
| 367500000X Nurse Anesthetist, Certified Registered | |
| Enumeration Date | 2008-12-05 |
| Last Update Date | 2025-03-13 |