NPI | 1598448854 |
---|---|
Entity Type | Organization |
Authorized Contact | GINNY RENEAU Business Administrator 315-956-0935 |
Organization Subpart ? | No |
Primary Taxonomy | 207RB0002X Internal Medicine, Bariatric Medicine |
Enumeration Date | 2023-08-11 |
Last Update Date | 2023-08-11 |