| NPI | 1558930370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA POWELL Board Member 929-491-7700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care |
| 207RG0300X Internal Medicine, Geriatric Medicine | |
| Enumeration Date | 2021-06-24 |
| Last Update Date | 2023-10-18 |