| NPI | 1609136985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE WANSER Office Manager 954-786-9552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME75222) |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2012-05-21 |