| NPI | 1609573757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID FANT Business Director 864-365-6405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2023-02-09 |
| Last Update Date | 2024-01-29 |